Provider Demographics
NPI:1962854638
Name:BUFFALINO, BRITTANY (LAC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BUFFALINO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-2953
Mailing Address - Country:US
Mailing Address - Phone:970-379-6019
Mailing Address - Fax:
Practice Address - Street 1:411 E MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2953
Practice Address - Country:US
Practice Address - Phone:970-379-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002204171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist